Occlusion In Fixed Partial Denture

OCCLUSION IN
FIXED PARTIAL DENTURES
Guided By:-
Dr. Dilip Dhamankar (HOD)
Dr. Ravi Kumar C.M. (Prof.)
Dr. Meenaksi (Prof.)
Dr. DRV Kumar (Reader)
Dr. Arun Gupta(Reader)
Dr. Sonal Pamecha (Reader)
Dr. Manish Chadha (Senior Lect.)
Dr. Devendra Singh (Senior
Lect.)
Dr. Soham Prajapati
2nd Year PG,
Dept. of Prosthodontics
& Maxillofacial Prosthesis
Including Oral Implantology
13-3-2015

CONTENTS
• Introduction
• Terminologies
• Ideal occlusion
• Evolution of occlusion
• Concepts of Occlusion
– Bilaterally Balanced Occlusion3°
– Unilaterally Balanced Occlusion
– Mutually protected Occlusion.
– Organic occlusion
– Beyron’s occlusal concepts
– Biologic or physiologic occlusion
• Patient’s Adaptablity
OCCLUSION IN FIXED PARTIAL DENTURES 2/109

CONTENTS
• Occlusal Interferences
• Pathogenic Occlusion
• Complete Occlusal Rehabilitation
• Restoring Different Combinations
• Review of Literature
• Conclusion
• References

INTRODUCTION
• Peter E. Dawson stated, ”Patient lose their
teeth in two ways: either the teeth break
down, other supporting structures break
down”

INTRODUCTION
• Occlusion is such an important word in
Prosthodontics, that in the bible of
Prosthodontics, GLOSSARY OF PROSTHODONTICS
TERMS, when searched in its soft copy version, it
is repeated for no less than 60 times.
• Occlusion
– 1: the act or process of closure or of being
closed or shut off
– 2: the static relationship between the incising
or masticating surfaces of the maxillary or
mandibular teeth or tooth analogues
The Glossary of Prosthodontic Terms, 8th Edition J Prosthet Dent 2005;81:63.

INTRODUCTION
• Articulation
– The static and dynamic contact relationship
between the occlusal surfaces of the teeth during
function.

INTRODUCTION
• The contact of the maxillary and mandibular
teeth in various functional (mandibular)
movements is an important relationship that
should NOT be traumatic to the supporting
tissues and should allow an even load
distribution throughout the dental arch.

Terminologies
• CENTRIC RELATION
– the maxillomandibular relationship in which the
condyles articulate with the thinnest avascular
portion of their respective disks with the complex
in the anterior-superior position against the shapes
of the articular eminencies.
– This position is independent of tooth contact.
– This position is clinically discernible when the
mandible is directed superior and anteriorly.
– It is restricted to a purely rotary movement about
the transverse horizontal axis (GPT-5)
OCCLUSION IN FIXED PARTIAL DENTURES
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Terminologies
• MAXIMUM INTERCUSPAL POSITION (MI)
– The complete intercuspation of the opposing teeth
independent of condylar position, sometimes
referred to as the best fit of the teeth regardless of
the condylar position—called also maximal
intercuspation
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Terminologies
• Centric Occlusion
– The occlusion of
opposing teeth
when the
mandible is in
centric relation.
This may or may
not coincide with
the maximal
intercuspal
position.
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Points To Clear
– It is clear from the definitions that in natural
dentition, MI position need not coincide with CR.
– When fixed and removable prosthesis are
fabricated with existing natural teeth, they may be
made to coincide with the existing normal MI
position, if sufficient natural teeth are present to
guide the occlusion.
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Points To Clear
– MI position is made to coincide with CR only when
there are insufficient occlusal contacts existing to
guide the occlusion.
– This is different from complete dentures where MI
position is given at CR.
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IDEAL OCCLUSION
• Ideal occlusion can be defined as an occlusion
which is compatible with stomatognathic
system providing efficient mastication and
good esthetics without creating physiologic
abnormalities.
Hobo(1978)
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IDEAL OCCLUSION
– Characteristics
• Stable Posterior contact with vertically directed
resultant forces.
• MIP coincident with CR along with freedom in centric.
• No posterior contact in ecentric mandibular
movements.
• Contact of anterior teeth in harmony with functional
jaw movement.
• Occlusion in Angle’s Class I
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IDEAL OCCLUSION
– Angle’s Class I
– If the mesiobuccal cusp of
the maxillary first molar is
aligned with the buccal grove
of the mandibular 1st molar.
– Orthodontic textbooks have
traditionally described an
arbitrary 2 mm for horizontal
overlap and vertical overlap
as being ideal.
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IDEAL OCCLUSION
– For most patients, however,
greater vertical over lap is
desirable, to prevent
undesirable posterior contact
as a result of flexing of the
mandible during mastication
Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics.
3rd ed. St. Louis: Elsevier; 2000. p. 110-144
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IDEAL OCCLUSION
– Importance of Ideal Occlusion
• Use it as a benchmark for assessment of pre-
treatment records and examination (diagnostic cast).
• Correcting TMD and occlusal interferences (if they
exist) before commencing restorative procedures.
• For final prosthodontic rehabilitation - to accomplish
this a confirmative approach (where patients
pretreatment occlusion is retained for the
prosthodontic rehabilitation), or a reorganized
approach (where a change in occlusal scheme is
planned) is utilizied.
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Concepts of Occlusion
• These can be categorized as
– Bilaterally Balanced Occlusion, 3°
– Unilaterally Balanced Occlusion, and
– Mutually protected Occlusion.
• However, since restorative treatment
requirements vary, the clinician should
understand possible combinations of occlusal
schemes and their advantages, disadvantages,
and indications.
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Bilaterally Balanced Occlusion
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Unilaterally Balanced Occlusion
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Mutually protected Occlusion
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• FERDINAND GRAF SPEE was one of the earliest
proposed theories -Bilateral Balanced
Occlusion.
Definition
• The bilateral, simultaneous, anterior, and
posterior occlusal contact of teeth in centric
and eccentric positions
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• In complete denture fabrication, this tooth
arrangement helps maintain denture stability
because the nonworking contact prevents the
denture from being dislodged.
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• However, as the principles of bilateral balance
were applied to the natural dentition and in
fixed prosthodontics, it proved to be
extremely difficult to accomplish, even with
great attention to detail and sophisticated
articulators.
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• In addition, high rates of failure resulted.
• An increased rate of occlusal wear, increased or
accelerated periodontal breakdown, and
neuromuscular disturbances were commonly
observed.
• The last were often relieved when posterior
contacts on the mediotrusive (NON-WORKING)
side were eliminated in an attempt to eliminate
unfavorable loading. Thus the concept of a
unilaterally balanced occlusion (group function)
evolved.
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(GROUP FUNCTION)
• It is based on Schyler’s Concept
Definition:-
Multiple contact relations between
maxillary and mandibular teeth, in lateral
movements on the working side, whereby
simultaneous contact of several teeth acts as a
Group to distribute occlusal forces
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(GROUP FUNCTION)
• In a unilaterally balanced articulation,
excursive contact occurs between all opposing
posterior teeth on the laterotrusive (working)
side only. On the mediotrusive (nonworking)
side, no contact occurs until the mandible has
reached centric relation.
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(GROUP FUNCTION)
• Thus, in this occlusal arrangement the load is
distributed among the periodontal support of
all posterior teeth on the working side. This
can be advantageous if, for instance, the
periodontal support of the canine is
compromised.
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(GROUP FUNCTION)
• While on the working side, occlusal load is
distributed during excursive movement, and
the posterior teeth on the nonworking side
do not contact.
• In the protrusive movement, no posterior
tooth contact occurs.
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(GROUP FUNCTION)
• While on the working side, occlusal load is
distributed during excursive movement, and
the posterior teeth on the nonworking side
do not contact.
• In the protrusive movement, no posterior
tooth contact occurs.
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(GROUP FUNCTION)
• Long Centric (Freedom in centric)
– As the concept of unilateral balance evolved, it was
suggested that allowing some freedom of movement
in an anteroposterior direction is advantageous. This
concept is known as long centric.
– Schuyler was one of the first to advocate such an
occlusal arrangement.
– He thought that it was important for the posterior
teeth to be in harmonious gliding contact when the
mandible translates from centric relation forward to
make anterior tooth contact.
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(GROUP FUNCTION)
• Long Centric.
– Others have advocated long centric because
centric relation only rarely coincides with the
maximum intercuspation position in healthy
natural dentitions.
– However, its length is arbitrary. At given vertical
dimensions, long centric ranges from 0.5 to 1.5
mm in length have been advocated.
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(GROUP FUNCTION)
• Long Centric.
– This theory presupposes that the condyles can
translate horizontally in the fossae over a
commensurate trajectory before beginning to
move downward.
– It also necessitates a greater horizontal space
between the maxillary and mandibular anterior
teeth (deeper lingual concavity), allowing
horizontal movement before posterior
disocclusion.
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Mutually Protected Occlusion
• During the early 1960s, an occlusal scheme called
mutually protected occlusion was advocated by
Stuart and Stallard, based on earlier work by
D'Amico.
• In this arrangement, centric relation coincides
with the maximum intercuspation position.
• The six anterior maxillary teeth, together with the
six anterior mandibular teeth, guide excursive
movements of the mandible, and no posterior
occlusal contacts occur during any lateral or
protrusive excursions
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Mutually protected Occlusion
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• The relationship of the anterior teeth, or
anterior guidance, is critical to the success of
this occlusal scheme.
• In a mutually protected occlusion, the
posterior teeth come into contact only at the
very end of each chewing stroke, minimizing
horizontal loading on the teeth.
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• Concurrently, the posterior teeth act as stops
for vertical closure when the mandible returns
to its maximum intercuspation position.
• Posterior cusps should be sharp and should
pass each other closely without contacting to
maximize occlusal function.
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• Investigations of the neuromuscular
physiology of the masticatory apparatus
indicate advantages associated with a
mutually protected occlusal scheme.
• However, in studies involving unrestored
dentitions, relatively few occlusions can be
classified as mutually protected
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• Advantages
– Patient’s tolerence
– Ease of Construction
• Disadvantages
– Periodontally weak anterior teeth
– Missing Canine
– Class II and Class III situation
– Cross-bite situation
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Optimum Occlusion
• In an ideal occlusal arrangement, the load
exerted on the dentition should be distributed
optimally.
• Occlusal contact has been shown to influence
muscle activity during mastication.
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Optimum Occlusion
• Direct Effect
– Any restorative procedures that adversely affect
occlusal stability may affect the timing and
intensity of elevator muscle activity.
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Optimum Occlusion
• Horizontal forces on any teeth should be
avoided or at least minimized, and loading
should be predominantly parallel to the long
axes of the teeth.
• This is facilitated when the tips of the centric
cusps are located centrally over the roots and
when loading of the teeth occurs in the fossae
of the occlusal surfaces rather than on the
marginal ridges.
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Optimum Occlusion
• Horizontal forces are also minimized if
posterior tooth contact during excursive
movements is avoided. Nevertheless, to
enhance masticatory efficiency, the cusps of
the posterior teeth should have adequate
height.
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Optimum Occlusion
• The chewing and grinding action of the teeth
is enhanced if opposing cusps on the
laterotrusive side interdigitate at the end of
the chewing stroke.
• The mutually protected occlusal scheme
probably meets this criterion better than the
other occlusal arrangements.
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Features of Mutually Protected
Occlusion
1. Uniform contact of all teeth around the arch
when the mandibular condylar processes are
in their most superior position
2. Stable posterior tooth contacts with vertically
directed resultant forces
3. Centric relation coincident with maximum in-
tercuspation (intercuspal position) (CR = MI)
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Occlusion
4. No contact of posterior teeth in lateral or
protrusive movement
5. Anterior tooth contacts harmonizing with
functional jaw movements
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Occlusion
• In achieving these criteria, it is assumed that
(1) a full complement of teeth exists,
(2) the supporting tissues are healthy,
(3) there is no cross bite, and
(4) the occlusion is Angle Class I.
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Rationale.
• At first glance it might seem illogical to load the
single-rooted anterior teeth as opposed to the
multirooted posterior teeth during chewing.
• However, the canines and incisors have a distinct
mechanical advantage over the posterior teeth:
the effectiveness of the force exerted by the
muscles of mastication is notably less when
the loading contact occurs farther anteriorly.
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Rationale.
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Dawson (1974) stated that,
• “When canines cannot be used ,lateral
movements have posterior dïsclusion guided
by anterior teeth on the working side, instead
of canine alone”
• He called this “Anterior Group Function”
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Rationale.
(Dawson presented his Theory Of Nutcracker)
• The canine-with its long root, significant
amount of periodontal surface area, and
strategic position in the dental arch-is well
adapted to guiding excursive movements.
• This function is governed by pressoreceptors
in the periodontal ligament, receptors that are
very sensitive to mechanical stimulation.
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Rationale.
• The elimination of posterior contacts during
excursions reduces the amount of lateral force
to which posterior teeth are subjected.
• Therefore, molars and premolars in group
function are subjected to greater horizontal
and potentially more pathologic force than
the same teeth in a mutually protected
occlusion.
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Organic occlusion features by
THOMPSON (1967)
• CRP and MIP are coincident
• Posterior teeth are in a cusp fossa relation, one tooth to
one tooth contact
• Each functional cusp contacts the occlusal fossa at three
points
• In protrusion maxillary incisors guide the mandible and
disocclude the posteriors
• In lateral movements – lingual surface of maxillary canine
glides along the distal inclines of mandibular canine and
mesial ridge of 1st premolar cusp
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BEYRON’S OCCLUSAL CONCEPTS
• Based on functional convenience and avoidance of discomfort.
• An optimal occlusion would be one that requires less muscular
activity and is in harmony with the neuromuscular system and TMJ.
• Beyron revealed that the majority of the subjects had
anteroposterior slide, in the Centric Position , in the range of 0 to 2
mm.
• Only 10% of them presented a coincidence of CO=CR.
• He also advocated freedom in centric concept & canine guided
occlusion
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BIOLOGIC OR PHYSIOLOGIC
OCCLUSION
• It is defined as an occlusion in which a
functional equilibrium or state of homeostasis
exist between all tissues of masticatory
system.
• A physiologic occlusion implies a balance
between occlusal stress and tissue resistance.
• The biologic processes and local
environmental factors are in balance.
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Patient’s Adaptablity
Shillingburg HT, Hobo S, Whitsett LD, Jacobi R, Brackett SE. Fundamentals
of fixed prosthodontics. 3rd ed. Chicago: Quintessence; 1997.p..
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Occlusal Intereferences
• Interferences are undesirable occlusal
contacts that may produce mandibualar
deviation during closure to maximum
intercuspation or may hinder smooth passage
to and from the intercuspal position.
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Occlusal Interferences
• Four types of interferences:
– Centric Interference
• Mandible is closed in centric relation until initial tooth
contact occurs.
• If increasing the the closing forces deflects the
mandible, premature contact or interference exists.
• Leads to deflection of the mandible, can be in a
posterior, anterior and/or lateral directions.
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– Centric Interference
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– Working Interference
• Occurs when there is contact between the maxillary
and mandibular posterior teeth on the working side
and this causes anterior teeth to disocclude.
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and mandibular posterior teeth on the working side
and this causes anterior teeth to disocclude.
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Shillingburg HT, Hobo S, Whitsett LD, Jacobi R, Brackett SE. Fundamentals of
fixed prosthodontics. 3rd ed. Chicago: Quintessence; 1997.p..
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– Non-Working Interference
and mandibular posterior teeth on the nonworking
side when the mandible moves in lateral excursions.
• Destructive in nature because of non-axial nature of
forces causing leverage of mandible
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– Non-Working Interference
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– Protrusive Interference
• Occurs when distal facing inclines of maxillary posterior
teeth contacts the mesial facing inclines of mandibular
posterior teeth during protrusive movement.
• These are destructions forces due to closeness of teeth
to the muscles, non-axial nature of forces and inability
of patient to incise food.
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– Protrusive Interference
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• Interferences may lead to pathologic occlusion
and should be assessed and corrected if
needed, with the aid of mounted diagnostic
casts before prosthetic rehabilitation is
commenced.
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PATHOGENIC OCCLUSION
• A pathogenic occlusion is defined as an
occlusal relationship capable of producing
pathologic changes in the stomatognathic
system.
• In such occlusions sufficient disharmony exists
between the teeth and the TMJs to result in
symptoms that require intervention
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• Signs & Symptoms
– Teeth
• Mobility
• Open contacts
• Abnormal wear like fracture or chipping of incisal edges
– Periodontium
• Chronic Periodontal disease
• Widened PDL Space (Radiographically)
• Tooth Movement and A compromised C:R Ratio.
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• Trauma From Occlusion
– There is no convincing evidence that chronic
periodontal disease is caused directly by occlusal
overload.
– However, a widened periodontal ligament space
(detected radiographically) may indicate
premature occlusal contact and is often associated
with tooth mobility
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• Trauma From Occlusion
– Similarly, isolated or circumferential periodontal
defects are often associated with occlusal trauma.
In patients with advanced periodontal disease
who have extensive bone loss, rapid tooth
migration may occur with even minor occlusal
discrepancies
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• Signs & Symptoms
– Musculature
• Chronic muscular fatigue leading to muscle spasm and
pain
• Restricted opening or trismus
• Myositis.
– TMJ
• Pain, Clicking or popping in the TMJ
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PATHOGENIC OCCLUSION TREATMENT
– This would include the following depending on the
cause for occlusal interference:-
– Short Term Treatment
• Occlusal Splints/devices.
– Used for short period and provide following
benefits:
» Serve to deprogram the occlusion such that
future restoration in centric relation is easily
accomplished
V Rangarajan, Textbook Of Prosthodontics, Pg 500
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– Short Term Treatment
• Occlusal Splints/devices.
– Used for short period and provide following
benefits:
» Act as a diagnostic tool in determining if a
proposed change in occlusal scheme will be
tolerated by the patient
» Also been beneficial in relieving myofacial pain.
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– Definitive treatment
• Compromising individually or in combination:
– Orthodontic treatment to correct malalignment
– Elimination of deflective occlusal cntacts through elective
grinding of interfering inclines
– Replacement of missing teeth to produce a more favorable
distribution of force.
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Complete Occlusal Rehabilitation
• Occlusal rehabilitation is defined as the restoration of
functional integrity of dental arch by the use of
inlays, crowns, bridges and partial dentures.
Shetty et al, PHILOSOPHIES IN FULL MOUTH REHABILITATION – A SYSTEMATIC
REVIEW , Int J Dent Case Reports,Nov-Dec 2013, Vol.3, ,No. 3
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• INDICATIONS FOR FULL MOUTH REHABILITATION
– The restoration of multiple teeth which are
missing, worn, broken down or decayed.
– To replace improperly designed and executed
crown and bridge framework.
– Treatment of temporomandibular disorders is also
advised, though caution is advised.
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Pankey-Mann- Schulyer Philosophy Of
• One of the most practical philosophies is the
rationale of treatment that was originally organized
into a workable concept by Dr. L.D. Pankey utilizing
the principles of occlusion espoused by Dr. Clyde
Schuyler.
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• Schuyler’s principles were
– A static co-ordinated occlusal contact of the maximum
number of teeth when the mandible is in centric
relation.
– An anterior guidance that is in harmony with
function in lateral eccentric position on the
working side.
– Disclusion by the anterior guidance of all posterior
teeth in protrusion.
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• Schuyler’s principles were
– Disclusion of all non-working inclines in lateral
excursions.
– Group function of the working side inclines in
lateral excursions.
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• Sequence of Treatment
– Part 1- examination, diagnosis, treatment planning
– Part 2- harmonization of anterior guidance for best
possible esthetics, function and comfort
– Part 3- selection of occlusal plane and restoration of lower
posterior occlusion in harmony with anterior guidance n a
manner that will not interfere with condylar guidance.
– Part 4- restoration of upper posterior occlusion in harmony
with anterior and condylar guidance.
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Pankey-Mann- Schulyer Philosophy
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• Advantages
– It is possible to diagnose and plan the treatment
for entire rehabilitation before preparing a single
tooth.
– It is a well- organized logical procedure that
progresses smoothly with less wear and tear on
the operator, patient and technician. There is
never a need for preparing or building more than
8 teeth at a time.
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• Advantages
– It divides the rehabilitation into separate series of
appointments. It is neither necessary nor
desirable to do the entire case at one time.
– There is no danger of getting at sea and losing
patient’s vertical dimension. The operator always
has an idea where he is at all times.
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• Advantages
– The functionally generated path and centric
relation are taken on the occlusal surface of the
teeth to be rebuilt at the exact vertical dimension
to which the case will be reconstructed.
– All posterior occlusal contours are programmed by
and are in harmony with both condylar border
move ments and a perfected anterior guidance.
– There is no need for time consuming techniques
and complicated equip ment.
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• Advantages
– Laboratory procedures are simple and controlled
to an extremely fine degree by the dentist.
– The PMS philosophy of occlusal rehabilitation can
fulfill the most exacting and sophisticated
demands if the operator understands the goals of
optimum occlusion
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HOBO’ S TWIN STAGE PHILOSOPHY
• In order to provide disocclusion, the cusp angle should
be shallower than the condylar path.
• To make a shallower cusp angle in a restoration, it is
necessary to wax the occlusal morphology to produce
balanced articulation so the cusp angle becomes parallel
to the cusp path of opposing teeth during eccentric
movement.
• Since anterior teeth help produce disocclusion, when a
dental technician waxes the occlusal morphology and
tries to reproduce a shallower cusp angle, the anterior
portion of the working cast becomes an obstacle.
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• Also, when fabricating the anterior teeth to produce
disocclusion, some guidance should be incorporated. In
this methodical approach described by Hobo, a cast with
a removable anterior segment is fabricated.
• Reproduce the occlusal morphology of the posterior
teeth without the anterior segment and produce a cusp
angle coincident with the standard values of effective
cusp angle (Referred to as ‘Condition’).
• Secondly, reproduce the anterior morphology with the
anterior segment and provide anterior guidance which
produces a standard amount of disocclusion (Referred to
as ‘Condition 2’).
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• Secondly, reproduce the anterior morphology with
the anterior segment and provide anterior guidance
which produces a standard amount of disocclusion
(Referred to as ‘Condition 2’).
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Difference
• In the Twin Stage
procedure, the cusp
angle was considered as
the most reliable
determinant of
occlusion. This was in
accordance with the
proven data from
studies that cusp angle
was 4 times more
reliable than condylar
and incisal paths.
Pankey Mann Schyuler’s
philosophy advocates that
condylar guidance does not
dictate anterior guidance.
Thus it believes in
harmonization of the anterior
guidance for best possible
esthetics, function and
comfort and the
determination of an occlusal
plane based on anterior
guidance.
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RESTORING DIFFERENT COMBINATIONS
PROSTHESIS POSITION
ICP/CR
ARTICULATOR AND
RECORDS
OCCLUSAL
MORPHOLOGY
Single
crown
ICP Simple hinge Conform to
occlusal
Morphology
FPD- one
quadrant ICP
Semiadjustable
/anterior guidance
Conform to
occlusal
Morphology
Several
quadrants
Long
centric
Fully
Adjustable / anterior
guidance and
condylar
guidance
Group
function is
desired/cusp
to fossa
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Review of Literature
• Pullinger in 1988 studied of occlusal variables
associated with joint tenderness and
dysfunction found ICP anterior to RCP in
association with bilateral occlusal stability may
be protective.
Pullinger AG, Seligman DA, Solberg WK. Temporomandibular disorders. Part II:
Oc- clusal factors associated with temporomandibular joint tenderness and
dysfunction. J Prosthet Dent 1988;59:363-7.
100/109

• In 1988, Agerberg et al studied of occlusal
interference frequency between centric
relation and centric occlusion or nonworking
contacts that prevented group function and
observed that majority of individuals had
deflective contacts that did not appear to
interfere with mastication.
Agerberg G, Sandstrom R. Frequency of occlusal interferences: a clinical study
in teenagers and young adults. J Prosthet Dent 1988;59:212-7.
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• In 2004, Occlusal wear studied and related to
risk factors such as bruxism, gender, and social
situations and it was found factors for high
occlusal wear: bruxism, male gender, loss of
molar contact, edge-to-edge incisor relations,
unemployment.
Bernhardt O, Gesch D, Splieth C, Schwahn C, Mack F, Kocher T, et al. Risk
factors for high occlusal wear scores in a population-based sample: results of
the Study of Health in Pomerania (SHIP). Int J Prosthodont 2004;17:333-9.
102/109

• The occlusal scheme can be classified by the location
of the occlusal contact made by the functional cusp
on the opposing tooth in centric relation
• There are two types:
– cusp-fossa
– cusp-marginal ridge
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Occlusal Scheme

• The cusp-marginal ridge relation is the type of
occlusal scheme in which the functional cusp
contacts the opposing occlusal surfaces on the
marginal ridges of the opposing pair of teeth, or in a
fossa.
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Cusp-Marginal Ridge

• The cusp-fossa relation is an occlusal pattern in
which each functional cusp is nestled into the
occlusal fossa of the opposing tooth
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Cusp-Fossa

• Although considered to be an ideal occlusal pattern,
it is rarely found in its pure form in natural teeth.
• Each centric cusp should make contact with the
occlusal fossa of the opposing tooth at three points.
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Cusp-Fossa

• The contact points are on the mesial and distal incline and the
inner facing incline of the cusp, producing a tripod contact.
Since the cusp tip itself never comes in contact with the
opposing tooth, the cusp tip can be maintained for a long
time with a minimum of wear
107/109
Cusp-Fossa

• The contact points are on the mesial and distal incline and the
inner facing incline of the cusp, producing a tripod contact.
108/109
Cusp-Fossa

• Tripodization. It is logical to see but difficult to
accomplish. It requires each cusp contacting an
opposing fossae be developed such that it produces
three contacts surrounding the actual tip.
109/109
TRIPOZIDATION

Cusp -fossa Cusp –marginal
ridge
Location of
occlusal contact
on opposing tooth
Occlusal fossa Occlusal fossae
and marginal
ridges
Relation with
opposing teeth
Tooth –to - tooth Tooth-to-two-
teeth
advantages Occlusal forces
directed parallel
to long axis of
tooth- very little
lateral stress
Most natural type
of occlusion -95%
of adults. Can be
used for single
restorationswww.indiandentalacademy.com
Classification of Occlusal Arrangements

Classification of Occlusal
Arrangements
Cusp -fossa Cusp –marginal ridge
Disadvantages Rarely found in
natural teeth – used
only when restoring
several contacting
teeth
Food impaction and
displacement of
teeth may arise if
the functional cusps
wedge into the
lingual embrasure
Applications Full mouth
reconstruction
Most cast
restorations
www.indiandentalacademy.com

Conclusion
• Occlusion of FDP with the antagonist should
be achieved favorably in order to fulfill the
requirements of mastication, aesthetics,
speech, and prevention of TMJ dysfunction.
112/109

References
1. The Glossary of Prosthodontic Terms, 8th Edition J
Prosthet Dent 2005;81:63.
2. Rosenstiel SF, Land MF, Fujimoto J. Contemporary
fixed prosthodontics. 3rd ed. St. Louis: Elsevier; 2000.
p. 46-64.
3. Shillingburg HT, Hobo S, Whitsett LD, Jacobi R,
Brackett SE. Fundamentals of fixed prosthodontics.
3rd ed. Chicago: Quintessence; 1997.p. 85-103, 191-2.
4. V Rangarajan, Textbook Of Prosthodontics, pg 470
5. Joseph E. Ewing, Fixed Parial Prosthesis, 2nd Edition,
14-20.
113/109

References
6. Bernhardt O, Gesch D, Splieth C, Schwahn C, Mack F, Kocher T, et al. Risk
factors for high occlusal wear scores in a population-based sample:
results of the Study of Health in Pomerania (SHIP). Int J Prosthodont
2004;17:333-9.
7. Agerberg G, Sandstrom R. Frequency of occlusal interferences: a clinical
study in teenagers and young adults. J Prosthet Dent 1988;59:212-7.
8. Pullinger AG, Seligman DA, Solberg WK. Temporomandibular disorders.
Part II: Oc- clusal factors associated with temporomandibular joint
tenderness and dysfunction. J Prosthet Dent 1988;59:363-7.
9. Shetty et al, PHILOSOPHIES IN FULL MOUTH REHABILITATION – A
SYSTEMATIC REVIEW , Int J Dent Case Reports,Nov-Dec 2013, Vol.3, ,No.
3
10. Pokorny et al, Occlusion for fixed prosthodontics: A historical perspective
of the gnathological influence , JPD, Volume 99 Issue 4, 299-306
114/109

Thank You
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Occlusion In Fixed Partial Denture

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